SLIDING FEE PROGRAM
Patient
Guide
What is
the Sliding Fee Program?
Sacopee Valley Health
Center is able to
provide sliding fees to patients who are eligible for our Sliding Fee
Program. Discounts are based on income and family size. Bills are
reduced after all other sources of payment have been applied. If you
feel that you may be eligible for a discount, please pick up an
application form in the waiting room, in exam rooms, and from any
member of our staff. You can also print out the form provided
here.
You
can apply
for the Sliding Fee
Program at any time of the year. Once you qualify, your enrollment
lasts for one year. How do I Apply? You need to fill out
an application
form. Please take a form from the waiting area, or ask any member of
the Sacopee Valley Health Center (SVHC) staff to give you one. You can
also print out the form provided here.
When
Can I Apply?
When
you fill out your
application, you must attach the following:
- Proof of
current family income
(paycheck stubs, copies of unemployment checks, Social Security checks,
etc.)
- If you
are self-employed, you also
need to give us a copy of your latest tax return
If you are
unable to provide this
information, please speak to SVHC’s Social Services
Coordinator, Jamie
Gleason. If there are special issues you would like us to consider when
we review your application, please write them on a separate piece of
paper.
All
information you provide us in your
application is kept completely confidential.
What
Services are
Covered?
Most Health Center
services are covered.
However, the amount of the discount depends on what the service is. You
will receive a letter explaining which services are discounted and by
how much.
When
Does My Sliding
Fee Discount Run
Out?
Your sliding fee
discount runs out
twelve months after your date of enrollment. Please submit a new
application before your expiration date to avoid a gap in fee discount
coverage.
I Have
More
Questions. Who Can I Ask?
Call 207-625-8126 and
ask for Jamie
Gleason, our Social Services Coordinator. She will be happy to
help you.
Other Benefits of our Sliding Fee
Program
- Some
services provided at Maine
Medical Center or MMC Diagnostic Center may also be discounted.
- Some
services at Mercy Hospital are
also eligible for a discount for some enrollees. These include
laboratory, mammography, x-ray, cardiac and pulmonary testing.
- If you
are on the Sacopee Valley
Health Center Sliding Fee Program, you will qualify for a discount on
NorDx Lab Services provided at the Health Center.
You will
get more specific information
about these benefits once you are enrolled.
What
Else Should I
Know?
Sacopee Valley Health
Center (SVHC)
accepts Medicaid from both Maine and New Hampshire. Many people who are
eligible for the SVHC Sliding Fee Program may also be eligible for
Medicaid – now called MaineCare in the State of Maine. In
recent years,
eligibility has expanded to include many more people.
SVHC has a MaineCare Enrollment
Assistance Program. We can help you determine if you and your
family members are eligible to receive coverage under MaineCare. We
will also help you fill out the application and submit it to the
MaineCare Program.
Please call Social Services Coordinator
Jamie Gleason at 207-625-8126 for more information.
Do
You Qualify?
Sliding
Fee
Application
Sacopee
Valley Health Center is an Equal Opportunity Organization.
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